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Telemedicine Company Owner Sentenced to 7 Years in Prison for $56M Medicare Fraud Scheme
A 57-year-old telemedicine company owner was sentenced to 7 years in prison and ordered to pay $27.9 million in restitution for his role in a scheme to fraudulently bill Medicare for unnecessary durable medical equipment.
Reinaldo Wilson, formerly of Richmond Hill, Georgia, owned and operated two telemedicine companies located in Bayonne, New Jersey between 2017 and 2019. Through these companies, Wilson and others paid illegal kickbacks to medical providers to sign orders for orthotic braces for Medicare beneficiaries, even though the beneficiaries did not need the braces.
Wilson and others illegally sold the signed orders to purported marketing companies that often re-sold the orders to brace companies, which in turn submitted claims for the unnecessary braces to Medicare. Wilson and his co-conspirators at marketing companies cajoled beneficiaries into accepting as many braces as possible.
Providers working for Wilson’s telemedicine companies signed orders for four or more orthotics a piece for over 3,000 beneficiaries, and more than 40 beneficiaries received orders for 10 or more orthotics. Wilson also attempted to conceal his crimes by creating a new telemedicine company and convincing a member of his church that it was an investment opportunity. He took $20k from this member and had her open the company and bank accounts in her name, which he then took control of.
During the conspiracy, Wilson and others submitted over $56 million in false and fraudulent claims to Medicare, of which Medicare paid over $27.9 million.
Wilson pleaded guilty to conspiracy to commit wire fraud and health care fraud in March 2021. The FBI, IRS Criminal Investigations (IRS-CI), and HHS-OIG investigated the case. Trial Attorneys Darren C. Halverson and Nicholas K. Peone of the Criminal Division’s Fraud Section prosecuted the case.
Wilson’s sentence underscores the serious consequences for those who exploit Medicare for personal gain. The FBI will continue working with law enforcement partners to ensure anyone who abuses federal health care programs is exposed and brought to justice.
Mandatory Facts:
- Defendant: Reinaldo Wilson
- Criminal Charges: Conspiracy to commit wire fraud and health care fraud
- Location: Richmond Hill, Georgia
- Date: 2017-2019
- Sentence: 7 years in prison
- Dollar Amounts: $27.9 million in restitution, $56 million in false and fraudulent claims
Key Facts
- State: Federal
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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